Please complete and return to:

Mrs. Pamela Bye, Conference Officer, The IMA, Catherine Richards House, 16 Nelson Street, Southend-on-Sea, Essex SS1 1EF, UK. Tel: +44 (0)1702 354020. Fax: +44 (0)1702 354111. Email: imacrh@v-e.anglia.ac.uk.

MALE/FEMALE ............         TITLE ..................



SURNAME ........................ FORENAMES .....................................



INSTITUTION AT WHICH EMPLOYED (in full, including address) .....................



................................................................................



ADDRESS FOR CORRESPONDENCE .....................................................



................................................................................



TELEPHONE NO: .......................... FAX NO: ...............................



EMAIL ADDRESS: .................................................................


(please write clearly)



CONFERENCE FEE ......................... RESIDENTIAL FEE .......................



LATE REGISTRATION FEE ......... DIETARY REQUIREMENTS ...........................



SIGNATURE .............................. DATE ..................................



GRADE (if IMA/IBS Member) ......................................................

Payment

Please note a VAT invoice will automatically be issued to all applicants wishing

to attend the conference.  If, however, you require your invoice to be addressed

to your accounts department or any other payer please give full details below:



................................................................................



................................................................................



*Please charge my Access/Mastercard/Eurocard/Barclaycard/VISA/DELTA

 (delete as appropriate)



ACCOUNT NUMBER ................................... EXPIRY DATE .................



*If your card account address is different from the above address please enter

 here:



................................................................................



................................................................................



Since email is not a secure medium, credit card details are transmitted entirely

at your own risk. All cheques should be made payable to The Institute of Mathematics 

and its Applications

<< Move to UK Nonlinear News Issue 4 Index Page (May 1996).

Last Updated: 1st May 1996.